Michigan Flu Focus

Editor: Sue Kim, MPH

Michigan Flu Focus

Weekly Influenza Surveillance Report

Editor Email: KimS2@

January 24, 2020

Week Ending January 18, 2020 | WEEK 3

Vol. 17; No. 16

Michigan Influenza Activity

No Activity Sporadic

Local Regional

Widespread

*Clicking on the current activity level will direct you to the CDC webpage defining each activity level for the geographic spread of influenza

Updates of Interest

The Centers for Disease Control and Prevention (CDC) is closely monitoring an outbreak of respiratory illness caused by 2019 novel coronavirus (2019-nCoV), first identified in Wuhan, Hubei Province, China. The first confirmed case in the United States was announced on January 21, 2020. There are ongoing investigations to learn more.

Please visit the following link for more details. Link:

Influenza-associated Pediatric Mortality

Nationally, 54 influenza-associated pediatric deaths have been reported thus far for the 2019-2020 flu season. Two (2) pediatric influenza (B) deaths have been confirmed by MDHHS during this season.

Influenza-like Illness Outpatient Surveillance

Week Ending Jan 18, 2020

U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet)

Michigan participates in ILINet, a collaborative effort between the CDC, state and local health departments, and volunteer sentinel clinicians as part of Michigan's influenza surveillance. ILINet provides data on the total number outpatient visits to health care providers seen for any reason and the number of those patients with influenza-like illness (ILI). For this system, ILI is defined as fever (temperature of 100?F [37.8?C] or greater) and a cough and/or a sore throat without a known cause other than influenza.

Number of Reports and ILI % by Region in Michigan during this time period:

Region

C

N

SE

SW

No. of Reporters Total (34)

11

7

12

4

ILI %

1.3

3.5

4.2

1.4

Data is provisional and may change as additional reports are received.

10.0

Michigan Statewide ILINet and Syndromic Surveillance,

9.0

2019-2020

ILINet

8.0

Syndromic

7.0

ILINet Baseline

6.0

Syndromic ILI Baseline

5.0

4.0

3.0

2.0

1.0

0.0

Michigan ILI Activity

2.2%

(Last week: 2.3%)

Regional Baseline*: 1.9% A total of 321 patient visits due to ILI were reported out of 14,913 office visits during this period.

*Regional baseline is determined by calculating the

mean percentage of patient visits due to ILI during non-influenza weeks for the previous three seasons and adding two standard deviations

National Surveillance In the United States, 5.0% of outpatient

visits were due to ILI. (Last week: 4.7%) This is above the national baseline of 2.4%

Rate

5-Oct-19 12-Oct-19 19-Oct-19 26-Oct-19 2-Nov-19 9-Nov-19 16-Nov-19 23-Nov-19 30-Nov-19 7-Dec-19 14-Dec-19 21-Dec-19 28-Dec-19

4-Jan-20 11-Jan-20 18-Jan-20 25-Jan-20 1-Feb-20 8-Feb-20 15-Feb-20 22-Feb-20 29-Feb-20 7-Mar-20 14-Mar-20 21-Mar-20 28-Mar-20 4-Apr-20 11-Apr-20 18-Apr-20 25-Apr-20 2-May-20 9-May-20 16-May-20

Week Ending

Become an ILINET provider! Contact Shelly Doebler at DoeblerM@

Influenza-associated Hospitalization Surveillance Week Ending Jan 18, 2020

Influenza Hospitalization Surveillance Project (IHSP)

The CDC's Influenza Hospitalization Surveillance Network (FluSurv-NET) provides populationbased rates of laboratory-confirmed influenza-associated hospitalizations from October 1st through April 30th each year. Michigan participates as an IHSP state in FluSurv-NET for Clinton, Eaton, Genesee, Ingham, and Washtenaw Counties.

There were 26 (2 pediatric, 24 adult) influenza-associated hospitalizations reported to MDHHS for the IHSP during this time period. Since October 1st, 318 (66 pediatric, 252 adult) influenzarelated hospitalizations were reported in the catchment area for the 2019-2020 season.

Total IHSP Cases, 2014-15 through 2019-2020

160

140

120

Number of Cases

100

80

60

40

20

0

40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

MMWR Week

2014-15

2015-16

2016-17

2017-18

2018-19

2019-20

Washtenaw County was added in the 2017-2018 season

Join the

Influenza Sentinel Hospital Network (ISHN)!

What is it? ISHN is a group of hospitals in Michigan that voluntarily report weekly aggregate counts of influenza positive inpatients to assist MDHHS with statewide flu surveillance

How it works: As a participating hospital in the ISHN, you would complete a brief Survey Monkey every week containing: ? Number of hospitalizations

with a positive influenza test by age group during that time period ? The total number of hospitalizations due to any condition during that time period (if available)

The data you provide is aggregated by region and can assist providers and public health in recognizing changes in the age or geographic distribution of flu in this population.

If your facility is interested in participating or would like more details, please contact Sue Kim (KimS2@)

5-Oct-19 12-Oct-19 19-Oct-19 26-Oct-19 2-Nov-19 9-Nov-19 16-Nov-19 23-Nov-19 30-Nov-19 7-Dec-19 14-Dec-19 21-Dec-19 28-Dec-19

4-Jan-20 11-Jan-20 18-Jan-20 25-Jan-20 1-Feb-20 8-Feb-20 15-Feb-20 22-Feb-20 29-Feb-20 7-Mar-20 14-Mar-20 21-Mar-20 28-Mar-20 4-Apr-20 11-Apr-20 18-Apr-20 25-Apr-20 2-May-20 9-May-20 16-May-20

Laboratory (Virologic) Surveillance

There were 19 new positive influenza results (11C, 0N, 4SE, 4SW) reported by the

MDHHS Bureau of Laboratories (BOL) during this time period.

# of Positive Respiratory Virus Results by Region

C

N

SE

SW

Total

H1N1

57

26

23

46

152

H3N2

4

0

8

8

20

Infl B

69

6

55

86

216

Total

130

32

86

140

388

Data is provisional and may change as additional results are reported.

Number of Positive Specimens

115 110

Influenza Positive Test Results, 2019-2020

105

100

Flu A, no subtype

95 90

A, H1N1

85

A, H3

80

75

Flu B, no lineage

70 65

B, Yamagata

60

B, Victoria

55

50

45

40

35

30

25

20

15

10

5

0

Week Ending

Note: Flu B subtyping will be reported based on MDHHS BOL testing runs and will be backtracked into this graph Latest MDHHS BOL Flu B lineage determination run: January 17, 2020

Week Ending Jan 18, 2020

Michigan Sentinel Clinical Lab Network Respiratory Virus Data

Thirteen (13) sentinel clinical labs (3SE, 2SW, 6C, 2N) reported during this week

Influenza A: Influenza B:

Parainfluenza:

SE Region moderate ? high; increasing moderate ? high; decreasing

slightly elevated

RSV: moderate ?high; decreasing Adenovirus: slightly elevated

hMPV: elevated

Central Region Influenza A: elevated; variable Influenza B: moderate; some increases

Parainfluenza: sporadic?low

RSV: elevated; decreasing Adenovirus: low

hMPV: low ? slightly elevated

Influenza A: Influenza B:

Parainfluenza:

SW Region moderate; decreasing moderate ? high; some decreases sporadic ? low

RSV: moderate; variable Adenovirus: low

hMPV: low

Influenza A: Influenza B:

Parainfluenza:

RSV: Adenovirus:

hMPV:

North Region slightly elevated elevated; some increases

sporadic

low ? slightly elevated no activity sporadic

Congregate Setting Outbreaks

Week Ending Jan 18, 2020

There were 4 new respiratory outbreaks (2C, 0N, 0SE, 2SW) reported to MDHHS during this time period. Respiratory outbreaks for the 2019-2020 season are listed in the table below.

Facility Type Schools: K-12 & College

Long-term Care / Assisted Living Facility

Healthcare Facility Daycare

Homeless Shelter Correctional Facility

Other

Total

# of Congregate Setting Outbreaks by Region

C

N

SE

SW

1

0

0

0

4

5

3

9

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

0

5

5

3

10

Total

0

21

0 0 0 1 0 23

Did you know?

Congregate setting outbreaks of viral respiratory illnesses are required to be reported to your local health department? See:

? Influenza Guidance for Healthcare Providers

? Guideline for influenza and Respiratory Virus Outbreaks in Long-Term Care Facilities

# Outbrekas

10

Congregate Setting Outbreaks by Region, 2019-2020

9

C

8

N

7

SE

6

SW

5

4

3

2

1

0

5-Oct-19 12-Oct-19 19-Oct-19 26-Oct-19 2-Nov-19 9-Nov-19 16-Nov-19 23-Nov-19 30-Nov-19 7-Dec-19 14-Dec-19 21-Dec-19 28-Dec-19

4-Jan-20 11-Jan-20 18-Jan-20 25-Jan-20 1-Feb-20 8-Feb-20 15-Feb-20 22-Feb-20 29-Feb-20 7-Mar-20 14-Mar-20 21-Mar-20 28-Mar-20 4-Apr-20 11-Apr-20 18-Apr-20 25-Apr-20 2-May-20 9-May-20 16-May-20

Week Ending

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